CUCUTA, Colombia — After Luis Molina drove his wife home one day last month, she jumped out of the car and ran across the street to run a quick errand. When she came back, he was still in the driver’s seat.
“What are you doing?” Elizabeth Zambrano asked.
“I can’t move,” Molina replied.
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He then tumbled out of the car.
The numbness that had taken over Molina’s feet was the first sign that the 70-year-old had Guillain-Barré syndrome, a rare condition typically triggered by the body’s immune response to an infection. It causes a progressive paralysis that in most cases is temporary, but can lead to death.
Health officials around the world are investigating whether the mosquito-borne Zika virus that has swept through most of Latin America is responsible for an increase in GBS cases in several countries. (Researchers are also trying to determine if Zika can cause microcephaly — or abnormally small heads — in babies born to mothers who contract the virus during pregnancy.)
Brazil, Colombia, El Salvador, and several other countries have detected more GBS cases than usual, just as French Polynesia saw a surge of GBS cases during a Zika outbreak there in 2013 and 2014, according to the World Health Organization.
In Colombia, three people with Zika-associated GBS have died, and health officials are investigating six other deaths. The country typically reports 240 or so cases of GBS each year, but had 86 in just five weeks in December and January, a few months after Zika was identified in Colombia, according to the WHO.
Those statistics have to be taken with a grain of salt because Zika is so poorly understood and so difficult to test for — and because alarm about its rapid spread may have prompted erroneous reports. In Brazil, for example, scientists reviewing reports of microcephaly have found that hundreds of cases turned out not to be related to Zika — or not to be actual cases of microcephaly.
Here in Cúcuta, Molina’s family strongly suspects Zika is to blame for his case of GBS. His doctors have told them that’s quite likely.
True, Molina had not shown any of the common symptoms of Zika, such as body and headaches, fever, and rash. But neither do 80 percent of people who contract the virus. And Zika has been very active in Cúcuta. It’s the largest city in the state of Norte de Santander, in northeast Colombia, which has reported almost 5,000 cases of Zika. That’s more than any other province in Colombia.
The disease progressed rapidly after Molina was stricken.
On Jan. 14, the day he fell out of his car, he could not move his legs or left arm or shut his right eye, his family said. His relatives took him to a clinic, but the doctor there could not diagnose the problem. His son-in-law, Rafael Antonio Cañas, 40, had to hoist Molina into a wheelchair to help get him back home.
Molina did not move his arms or legs during the next few days. His family had to pick up his limbs for him, fighting against a rigidity that had taken over, they said.
“It’s so hard to see him like that,” said Zambrano, his wife of 45 years. “It’s cruel to see him.”
Molina was finally diagnosed by a private neurologist four days after he was first afflicted. He has been in intensive care ever since, sharing a hospital room with three other patients. His family visits daily. His granddaughter, 3-year-old Laura Gabriela Cañas, sends cards.
Molina’s face was never fully paralyzed, and he never lost the ability to talk. But for eight days, he needed breathing assistance, his family said. Over the course of his illness, he’s received 32 doses of immunoglobulin, brought in from Bogota. It’s believed to reduce the severity and duration of GBS paralysis.
A little over a week ago, Molina regained some movement in his arms, but still could not grasp anything. He still couldn’t generate much more than a wiggle in his legs.
The paralysis has been a heavy blow for Molina, who at 70 still helps run the family juice business and volunteers at church. He’s funny and easygoing, his family said, and he can repair anything. Most afternoons, he and his wife take walks together.
Though Zambrano granted permission, hospital officials would not let a STAT reporter and photographer visit Molina.
So Zambrano, 65, told her husband’s story in their living room, which was filled with family photos. As she spoke, a neighbor stopped by to ask how Molina was faring. “Oh, he’s doing better,” she said.
Physically, at least.
“He feels frustrated,” Zambrano said after her neighbor left. “He’s anxious to leave.”
Her own eyes filled with tears. “I am always with him,” she said. “I go everywhere with him. Now I feel alone.”
His family said Molina faces several months of physical therapy once he is released from the hospital. For now, a nephew with the strength to lift, rotate, and flex Molina’s limbs goes to the hospital to help with his recovery. It’s not easy: “He’s a big man,” Molina’s wife said.
Zambrano and Molina had planned to vacation in the Caribbean island of San Andrés, but his health forced them to postpone.
His family says he’s using the delayed vacation as motivation, pushing him to work toward recovery.
“When I get out,” Molina has told Zambrano, “we’re going to San Andrés.”